| NPI | 1467855429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41394) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4104) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |