| NPI | 1780958736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 303374) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 028056) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2023-02-20 |