| NPI | 1841715398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017033599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05737) |
| Enumeration Date | 2017-08-06 |
| Last Update Date | 2022-07-21 |