| NPI | 1912379256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65248) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 43136) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2024-04-09 |