| NPI | 1578245957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019692) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2024-05-17 |