| NPI | 1710103767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: KS 11-02980) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 2000170990) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |