| NPI | 1194419465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 304087) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 26256) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-06-08 |