| NPI | 1255677936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 38603) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031994) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2015-01-23 |