| NPI | 1891071759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 37673) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 3670) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2021-12-03 |