| NPI | 1861802522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL 0012616) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 3377) |
| 225100000X Physical Therapist (Licence: TX 1166253) | |
| Enumeration Date | 2014-05-04 |
| Last Update Date | 2014-05-04 |