| NPI | 1699100594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27381) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC 27381) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 12209) | |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2024-10-07 |