| NPI | 1558762492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04954) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014027056) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |