| NPI | 1154585685 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019406)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT297794)  | 
| Enumeration Date | 2008-07-14 | 
| Last Update Date | 2021-11-13 |