| NPI | 1003546151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022027724) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06996) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2026-02-03 |