| NPI | 1902979842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 35583) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6484) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2009-06-30 |