| NPI | 1578931952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-02940) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2015037218) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2019-09-19 |