| NPI | 1679963672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-05105) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014027201) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2020-11-10 |