| NPI | 1881000867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0016317) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-021417) |
| 2251S0007X Physical Therapist, Sports (Licence: OH PT.014932) | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2020-01-31 |