| NPI | 1861582785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006021629) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03632) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2010-11-03 |