| NPI | 1790938629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT34311) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: ID 2447) |
| 225100000X Physical Therapist (Licence: MA 21165) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2016-12-01 |