| NPI | 1104363787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: CO PTL.0013928) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: NY 037416) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |