| NPI | 1679853097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2012010189) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS T-03119) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2014-04-02 |