| NPI | 1578816468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4142) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 32145) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2023-08-03 |