| NPI | 1225419427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS T-04224) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-05-11 |