| NPI | 1174353304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 11818) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO Cp054963t) |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2026-05-11 |