| NPI | 1558772475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 39921) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 39921) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2019-12-17 |