| NPI | 1205193380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 301493) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NM A-0660) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2024-01-25 |