| NPI | 1962287599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-08131) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 12760) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2026-08-21 |