| NPI | 1629618095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 297899) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |