| NPI | 1679794051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 34710) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62 023644) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2023-07-01 |