| NPI | 1083619175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: KS 11-00650) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-07-08 |