| NPI | 1720141724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-03298) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2003020826) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-07-17 |