| NPI | 1023159258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1103503) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2005032728) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |