| NPI | 1629047691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0014563) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 02605) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-12-30 |