| NPI | 1174111918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0020220) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT36207) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2024-12-12 |