| NPI | 1740704592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 301985) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 039479-1) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2023-03-21 |