| NPI | 1639479876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-00784) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO RO451) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2010-10-21 |