| NPI | 1780876474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT-004644) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62 024740) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |