| NPI | 1134180821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0003209) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 4519) |
| 208100000X Physical Medicine & Rehabilitation (Licence: WI 5742024) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2018-04-03 |