| NPI | 1053053264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216040) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 301942) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2023-10-13 |