| NPI | 1972020782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017027005) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06098) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2019-04-26 |