| NPI | 1104127836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 38558) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 030664-1) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2015-01-09 |