| NPI | 1174801245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0016217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1559) |
| 225100000X Physical Therapist (Licence: NE 3034) | |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2019-04-03 |