| NPI | 1205370483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1102435) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: KS 11-02435) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2022-08-23 |