| NPI | 1881241834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63427) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06290) |
| 225100000X Physical Therapist (Licence: MO 2019021794) | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-23 |