| NPI | 1619121068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT12219) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: CA PT12219) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2008-11-12 |