| NPI | 1659371110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-01654) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2002019242) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2007-07-08 |