| NPI | 1760991319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017026987) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05783) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-10-18 |