| NPI | 1851707905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CO 0012668) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 0012668) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2023-10-26 |