| NPI | 1700051109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 9573) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 13871) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2011-11-21 |