| NPI | 1114375508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05325) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2020-06-16 |