| NPI | 1760759526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT 3592) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 38438) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2019-06-13 |