| NPI | 1104365733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0014485) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO PTL.0014485) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2020-09-24 |