| NPI | 1992364467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020038099) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06177) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2020-11-17 |