| NPI | 1619386265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0016336) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT2834) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2019-12-17 |