| NPI | 1609335124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-05836) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018044733) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2020-02-05 |