| NPI | 1528307592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 9226) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TN 9226) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: TN 9226) | |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2020-04-13 |