| NPI | 1407120694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 11584) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IA 079154) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2017-01-18 |