| NPI | 1063780922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06573) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2021-09-02 |