| NPI | 1003285537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CO PTL.0013636) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-06700) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2021-06-22 |