| NPI | 1164517793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PT20889) |
| Additional Taxonomies | 225500000X Specialist/Technologist (Licence: CA PT20889) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |