| NPI | 1558614123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 39216) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39216) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2021-08-20 |