| NPI | 1144621699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211793) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 10144) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2021-03-22 |