| NPI | 1194784355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0013089) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10382-024) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-10-24 |