| NPI | 1720322704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: KS 1106365) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT39574) |
| 225100000X Physical Therapist (Licence: MO 2016023776) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2022-09-23 |