| NPI | 1669872586 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41512)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1230116)  | 
| Enumeration Date | 2014-08-27 | 
| Last Update Date | 2014-08-27 |