| NPI | 1790895480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT003644) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 003644) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-12-08 |