| NPI | 1902462773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A202897) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208VP0000X (Licence: CA A202897) | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2026-08-06 |