| NPI | 1811512486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 4148) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTLP.0000166) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-10-13 |