| NPI | 1730572405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3774) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT-42466) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-09-01 |