| NPI | 1316975493 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0016698) | 
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CO PTL.0016698) | 
| Enumeration Date | 2006-06-29 | 
| Last Update Date | 2020-01-24 |