| NPI | 1083360986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022031608) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06979) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-08-10 |