| NPI | 1487265302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 17708) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: MT PTP-PT-LIC-19352) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2022-07-01 |