| NPI | 1912488727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015771) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR CP000064T) |
| 225100000X Physical Therapist (Licence: TN 11160) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2022-02-17 |