| NPI | 1861740995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0011652) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04409) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2018-03-14 |