| NPI | 1013577899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2019030132) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06397) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2020-06-23 |