| NPI | 1548650096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 294470) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011512A) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2021-10-22 |