| NPI | 1700552148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1107139) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017849) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2022-09-08 |