| NPI | 1003482480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019408) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2020004351) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2024-01-08 |