| NPI | 1508413162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO PTA.0014625) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO MT.0015505) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |