| NPI | 1689210619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0017674) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1325725) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2023-06-16 |