| NPI | 1205196342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS KS11-04158) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2013032376) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2013-09-02 |