| NPI | 1356647093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208052) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 36363) |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2015-01-24 |