| NPI | 1669777017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 005739) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: 005739) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2025-03-25 |