| NPI | 1063861110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO CP056547T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05407) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2026-05-14 |