| NPI | 1396855748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: MO 2007030488) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 1103753) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-07-02 |