| NPI | 1942789276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400134020) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2024-01-10 |