| NPI | 1841765492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0017934) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 12030) |
| 225100000X Physical Therapist (Licence: NY 043214) | |
| 225100000X Physical Therapist (Licence: VA 2305212434) | |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-09-16 |