| NPI | 1154980035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 105060) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06123) |
| 225100000X Physical Therapist (Licence: MO 2019035818) | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2023-11-14 |