| NPI | 1619523826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018035) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT34882) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2023-10-16 |