| NPI | 1679025282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT301602) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10533) |
| 225100000X Physical Therapist (Licence: ME PT6136) | |
| 225100000X Physical Therapist (Licence: CO PTL.0018171) | |
| Enumeration Date | 2016-10-30 |
| Last Update Date | 2022-04-18 |