| NPI | 1679450035 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-07683) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2024026635) | 
| Enumeration Date | 2025-08-18 | 
| Last Update Date | 2025-08-18 |