| NPI | 1073211132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-033381) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0018323) |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2024-04-24 |