| NPI | 1174139778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1106447) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2020031969) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-25 |