| NPI | 1659707313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 7702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004306) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2015-03-02 |