| NPI | 1053321406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 18734) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 15320) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2010-02-05 |