| NPI | 1972158947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018602) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT34886) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2023-07-07 |