| NPI | 1588980759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: CA 24633) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 24633) |
| 2251X0800X Physical Therapist Orthopedic (Licence: CA 24633) | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2019-02-14 |