| NPI | 1972577500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 119884) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-02753) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2015-01-15 |