| NPI | 1982699278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 2266) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 15049) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2025-06-16 |