| NPI | 1043641590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0012198) |
| 225100000X Physical Therapist (Licence: SC 8474) | |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2021-09-02 |