| NPI | 1750665782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0014389) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9976) |
| 225100000X Physical Therapist (Licence: MO 2011031127) | |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2022-05-23 |