| NPI | 1003383514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: CA 304254) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2023-12-18 |