| NPI | 1578956215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 008412) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 291445) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2023-11-22 |