| NPI | 1770794976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-02002) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 111727) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2007-07-09 |