| NPI | 1154792661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT-1945) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0013645) |
| 225100000X Physical Therapist (Licence: CO PT4702) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2025-10-05 |