| NPI | 1689282899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 298539) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MT PTP-PTA-LIC-7628) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |