| NPI | 1497151716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 112130) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-02799) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |