| NPI | 1215463930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 300932) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000028458) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2021-09-05 |