| NPI | 1053854612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65235) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 292360) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2024-09-10 |