| NPI | 1982091963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015018391) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT4420) |
| 225100000X Physical Therapist (Licence: KS 11-05038) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2018-02-15 |