| NPI | 1932407020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: KS 11-07302) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1195108) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2024-11-04 |