| NPI | 1619509064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 308068) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 50525) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2025-08-12 |