| NPI | 1720194095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2003016640) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0011928) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-12-31 |