| NPI | 1285066837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 301538) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000014495) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2022-11-13 |