| NPI | 1407582943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06777) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: KS 11-06777) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-11-16 |