| NPI | 1952500555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 832) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: KS 11-02252) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |