| NPI | 1417408618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 300225) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OR AT-AT-10177290) |
| Enumeration Date | 2016-10-22 |
| Last Update Date | 2021-07-01 |