| NPI | 1912376641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 40071) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10085) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2022-01-03 |