| NPI | 1225660764 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 302379) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63580) | 
| Enumeration Date | 2020-02-12 | 
| Last Update Date | 2022-12-02 |