| NPI | 1366999054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0017308) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT33982) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2021-02-16 |