| NPI | 1053892364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015821) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 23939) |
| 225100000X Physical Therapist (Licence: VA 2305212285) | |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2024-02-21 |