| NPI | 1619156304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0018516) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT23575) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2022-08-09 |