| NPI | 1235400078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9030) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 22683) |
| 225100000X Physical Therapist (Licence: NC P17621) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2023-05-28 |