| NPI | 1700282712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209025) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |