| NPI | 1639434467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017007825) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05553) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2021-12-10 |