| NPI | 1518236256 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36849) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 36849) | 
| Enumeration Date | 2011-12-27 | 
| Last Update Date | 2021-03-18 |