| NPI | 1245441237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 16912) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CA 80680) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |