| NPI | 1356643803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 293158) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1178189) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2022-07-21 |