| NPI | 1356701098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: KS 1400632) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: KS 1400632) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |