| NPI | 1902137300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1102154) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO R0505) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2010-01-25 |