| NPI | 1790064525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PT5569) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT5569) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-08-10 |