| NPI | 1932191764 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11 01638) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01892) | 
| Enumeration Date | 2005-08-18 | 
| Last Update Date | 2007-12-12 |