| NPI | 1912396714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006596) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7635) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-05-29 |