| NPI | 1063968667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040609) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0015509) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: CO PTL.0015509) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2021-04-09 |