| NPI | 1568723823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06704) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2001029382) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2021-07-01 |