| NPI | 1346509577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 38771) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 2000000758) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |