| NPI | 1932808805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 19734) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA 117700) |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2024-05-06 |