| NPI | 1861841306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12673) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0013982) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-12-01 |