| NPI | 1205603404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 44265) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 305267) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2026-04-16 |