| NPI | 1205497872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1106160) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019022349) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-12-20 |