| NPI | 1679964506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT292210) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 2970) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2022-06-01 |