| NPI | 1063092732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0017605) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 299129) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2022-11-22 |