| NPI | 1114149978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 2790) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03294) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2009-03-10 |