| NPI | 1629790530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216089) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 302423) |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2024-08-15 |