| NPI | 1013212141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 12553) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 37475) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2018-12-17 |