| NPI | 1407908296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-01272) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO R1184) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |