| NPI | 1821210550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 001530) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 1530) |
| 2251P0200X Physical Therapist Pediatrics | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2024-08-20 |