| NPI | 1972232353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022028528) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-03954) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-07-26 |