| NPI | 1821736307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018452) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1331793) |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2022-06-24 |