| NPI | 1366713521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0013866) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT010027) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2019-06-25 |