| NPI | 1245909191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0017912) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37673) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |