| NPI | 1235540584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTLIC9666) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PT0012448) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2022-07-21 |