| NPI | 1023436631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: CA PT301174) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2013028745) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-05-15 |