| NPI | 1003169301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04451) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1079937) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |