| NPI | 1073121208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020025286) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06456) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-08-07 |