| NPI | 1497388151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24773) |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2022-10-11 |