| NPI | 1750948352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018266) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212755) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2023-09-20 |