| NPI | 1760902985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06268) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0014932) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-09-18 |