| NPI | 1912311473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2014024221) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04824) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-10-02 |