| NPI | 1194268003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 105667) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT292283) |
| Enumeration Date | 2016-11-24 |
| Last Update Date | 2021-02-16 |