| NPI | 1710361357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015023911) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0013304) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2025-12-01 |