| NPI | 1063078574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2019030129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT031999) |
| 225100000X Physical Therapist (Licence: KS 11-06316) | |
| 225100000X Physical Therapist (Licence: NY 052144) | |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2024-05-01 |