| NPI | 1902138415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018260) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT35309) |
| 225100000X Physical Therapist (Licence: CO 9003) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2010-02-08 |