| NPI | 1316537491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020026180) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06472) |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |