| NPI | 1972827319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1104048) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 25212) |
| Enumeration Date | 2010-03-14 |
| Last Update Date | 2010-03-14 |