| NPI | 1497061642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ZZ 17904) |
| 225200000X Physical Therapy Assistant (Licence: CA 8839) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2019-02-20 |