| NPI | 1003208802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24343) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 42258) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2019-02-18 |