| NPI | 1023739612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019421) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305215384) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2023-10-30 |