| NPI | 1194841643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2004021463) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03412) |
| 225100000X Physical Therapist (Licence: AR PT 4264) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2017-03-07 |