| NPI | 1912310459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 42669) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PA019582) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2015-09-18 |