| NPI | 1124401898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1101694) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 100165) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |