| NPI | 1760512438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-03354) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 20020076797) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |