| NPI | 1790865210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006006817) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 1103564) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |