| NPI | 1831266774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT291049) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 11473) |
| 225100000X Physical Therapist (Licence: RI PT01782) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2017-03-01 |