| NPI | 1164770830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-03751) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2012031798) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2022-04-17 |