| NPI | 1558032169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 300930) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 300930) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-09-23 |