| NPI | 1316285190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PT 39626) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT39626) |
| 225100000X Physical Therapist (Licence: MI 5501018246) | |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2018-03-17 |