| NPI | 1952870230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 298665) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 61865) |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2023-09-11 |