| NPI | 1104208545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3483) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05312) |
| 225100000X Physical Therapist (Licence: MO 2016020979) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-01-28 |