| NPI | 1205510047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2023042594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 16400-024) |
| 225100000X Physical Therapist (Licence: MO CP022431T) | |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-10-26 |