| NPI | 1578065462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-07349) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-03197) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2024-03-28 |