| NPI | 1912154790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 005104) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05009251A) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2008-08-22 |