| NPI | 1063175032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 14695) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA 14695) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |