| NPI | 1306198486 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11322) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 21790) | 
| Enumeration Date | 2012-10-12 | 
| Last Update Date | 2019-08-23 |