| NPI | 1255588554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL-10143) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 070402660) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2012-09-19 |