| NPI | 1952828816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017029238) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05732) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2023-03-23 |