| NPI | 1942420484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 000788) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05001195A) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2016-06-13 |