| NPI | 1326350620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 27669) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: CA 27669) |
| 2251S0007X Physical Therapist Sports (Licence: CA 27669) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: CA 27669) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2016-05-24 |