| NPI | 1679071096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 291889) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0015232) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2019-05-08 |