| NPI | 1205446309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 306835) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 50628) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2024-10-17 |