| NPI | 1457836264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41827) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 104112623-2401) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2021-12-10 |