| NPI | 1215538269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 19953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 25137) |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2026-03-04 |