| NPI | 1164912242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0017921) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-5550) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2022-01-18 |