| NPI | 1053788539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015029975) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05138) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2016-12-12 |