| NPI | 1689198681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: CA 293312) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 293312) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2023-11-27 |