| NPI | 1104435965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0017584) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NC P19782) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2022-01-20 |