| NPI | 1154041473 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0020694)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 29146)  | 
| Enumeration Date | 2022-08-29 | 
| Last Update Date | 2025-07-15 |