| NPI | 1902463516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019020588) |
| 225100000X Physical Therapist (Licence: ID PT6280) | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2025-06-23 |