| NPI | 1083981005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60064) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 38415) |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2017-11-30 |