| NPI | 1649810144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018845) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305213191) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2025-08-26 |