| NPI | 1639543192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT292562) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1263810) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2017-05-09 |