| NPI | 1669831905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2016003534) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05833) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2019-02-26 |