| NPI | 1447763537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT293759) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4398) |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2021-10-17 |