| NPI | 1649750365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018028) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT03098) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2022-01-24 |