| NPI | 1962407122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: KY PT004569) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: OH PT009184) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2014-01-17 |