| NPI | 1124581715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 304723) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042861) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-08-20 |