| NPI | 1730740945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2019027961) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06124) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2020-03-10 |