| NPI | 1922381102 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2010039345) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04231) | 
| Enumeration Date | 2011-09-23 | 
| Last Update Date | 2011-09-23 |