| NPI | 1578951166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2000167617) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-02941) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |