| NPI | 1639517741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012941) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305207977) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2015-03-25 |