| NPI | 1316331119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO PTL0013141) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NE 3435) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |