| NPI | 1376096362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2016023755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05313) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2023-10-10 |