| NPI | 1104366004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 17577) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0017577) |
| 225100000X Physical Therapist (Licence: TN 12319) | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2021-06-04 |