| NPI | 1083198618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT4531) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0015925) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-09-19 |