| NPI | 1255535340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: MO 2004030790) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: KS 11-03676) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2022-12-12 |