| NPI | 1174148480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH8127) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT6799) |
| 225100000X Physical Therapist (Licence: KS 11-05464) | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2023-11-27 |