| NPI | 1801266473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 100769) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 37204) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2016-07-14 |