| NPI | 1205960234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 3608) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: CO 3608) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2017-03-02 |