| NPI | 1003995929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 01936) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-01751) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |