| NPI | 1568033124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019273) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501010665) |
| 225100000X Physical Therapist (Licence: AZ CP028012T) | |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2024-02-22 |