| NPI | 1164940383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 6112) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0015091) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2022-07-21 |