| NPI | 1720636913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019867) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9809) |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2025-04-12 |