| NPI | 1104312958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64146) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 294950) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2023-03-30 |