| NPI | 1790396091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 008269) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT35901) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2021-07-20 |