| NPI | 1073593190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005003641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03404) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-08-19 |