| NPI | 1194185520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41194) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 9510) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2019-01-03 |