| NPI | 1811208606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 01711) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-01321) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |