| NPI | 1336415215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1105493) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-02250) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2016-08-22 |