| NPI | 1790194785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 22054) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 2395) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2015-07-22 |