| NPI | 1619379823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015307) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21335) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2022-12-02 |