| NPI | 1780900241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2010010441) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04069) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2010-04-08 |