| NPI | 1962993576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007379) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 003964) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-09-10 |