| NPI | 1366622219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9827) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: CO 9827) |
| 2251N0400X Physical Therapist Neurology (Licence: CO 9827) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: CO 9827) | |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2020-01-23 |