| NPI | 1114402146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 137691) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2024-05-06 |