| NPI | 1659818128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 297481) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 32665) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2021-05-11 |