| NPI | 1770824443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 31346) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0011967) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2024-01-05 |