| NPI | 1588598064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-08166) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO IA-0008403545) |
| Enumeration Date | 2026-06-10 |
| Last Update Date | 2026-08-10 |