| NPI | 1245665413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0015252) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1233712) |
| 225100000X Physical Therapist (Licence: MA 22389) | |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2018-05-15 |