| NPI | 1376264739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0021425) |
| 225100000X Physical Therapist (Licence: AZ LPT-034506) | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2026-08-06 |