| NPI | 1386846772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005020197) |
| Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural (Licence: MO 2005020197) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2016-05-26 |