| NPI | 1548627946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2008032044) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03624) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-15 |