| NPI | 1730414970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MO R0734) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: KS 11-01128) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: KS 11-01128) | |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2023-05-25 |