| NPI | 1821179094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: MO CO002926) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO R0693) |
| 225100000X Physical Therapist (Licence: KS 11-00312) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |