| NPI | 1366207854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2024004708) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-07559) |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2024-08-18 |