| NPI | 1871602623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 002305) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010231A) |
| 174400000X Specialist | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2021-03-18 |