| NPI | 1568631760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 39269) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 8180) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2012-11-05 |