| NPI | 1912217803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 33170) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 33170) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2022-01-28 |