| NPI | 1457736357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2011019286) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05014) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |