| NPI | 1407100746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018032325) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04200) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2023-11-01 |