| NPI | 1316344922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 15955) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 038308) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2018-10-12 |