| NPI | 1750932679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: WA PT61371687) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0016590) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2023-01-13 |