| NPI | 1205218062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 42155) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031893) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-06-29 |