| NPI | 1700964921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-00934) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO R0875) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |