| NPI | 1225686744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0017791) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007776) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2023-01-04 |