| NPI | 1740014455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 307725) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: L302568) |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2026-04-03 |