| NPI | 1598162349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41187) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT 5455) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |