| NPI | 1912645946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO CP014305T) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 2305215018) |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-10-03 |