| NPI | 1821174806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 003026) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KY 003026) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2015-10-12 |