| NPI | 1972184851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021026426) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06759) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2021-07-12 |