| NPI | 1578531836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT8986) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA PT8986) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA PT8986) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2011-10-03 |