| NPI | 1063899086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 112452) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03004) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |