| NPI | 1518164029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT6721) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 9233) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2007-07-08 |