| NPI | 1063752582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 4430) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT16876) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-02-20 |