| NPI | 1003956798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 40167) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NV 1656) |
| 146N00000X Emergency Medical Technician, Basic (Licence: CA E156417) | |
| 2251S0007X Physical Therapist, Sports (Licence: CA PT40167) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2021-02-25 |