| NPI | 1629749627 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 301007)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 64206)  | 
| Enumeration Date | 2021-09-21 | 
| Last Update Date | 2021-09-21 |