| NPI | 1811212483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 3773) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 5004902-2401) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2025-01-29 |