| NPI | 1316472566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT9072) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT 425) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |