| NPI | 1922667179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06146) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017155) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2023-11-09 |