| NPI | 1790313088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-7918) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 295519) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2022-11-16 |