| NPI | 1679046577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0016935) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1313988) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2022-04-01 |