| NPI | 1679081210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0011166) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2025-05-20 |