| NPI | 1700498508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT009179) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2020025063) |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2024-11-21 |