| NPI | 1376677682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO R1127) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7925) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2022-07-21 |