| NPI | 1619689502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO CP017375T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 14181) |
| Enumeration Date | 2022-12-22 |
| Last Update Date | 2022-12-22 |