| NPI | 1750836953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1105465) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018004462) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2022-10-27 |