| NPI | 1417944711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: FL 37057) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA 15842) |
| Enumeration Date | 2005-10-02 |
| Last Update Date | 2023-03-07 |