| NPI | 1417441643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018034641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-060161) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-09-20 |