| NPI | 1023396108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2010038793) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03737) |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2019-01-17 |