| NPI | 1275802456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36282) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031872) |
| Enumeration Date | 2011-12-18 |
| Last Update Date | 2019-07-12 |