| NPI | 1184292617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: CA PT300183) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046723) |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2021-06-11 |