| NPI | 1851865844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0016193) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2021-01-14 |