| NPI | 1770823932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0014907) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 005074) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2019-04-03 |