| NPI | 1780101840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS 14-03293) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS T-04828) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-12-15 |