| NPI | 1265669592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT21461) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: CA PT21461) |
| 2251X0800X Physical Therapist Orthopedic (Licence: CA PT21461) | |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2009-06-13 |