| NPI | 1114365707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012185) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8539716-2401) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2015-07-16 |