| NPI | 1811064348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 00470) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 7911) |
| 225100000X Physical Therapist (Licence: SC 3818) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |