| NPI | 1588688055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1102608) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 110766) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-09-11 |