| NPI | 1659596773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-03715) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2007026351) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-11-27 |