| NPI | 1003190067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT028083) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 8503) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2020-10-08 |