| NPI | 1942731146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208030) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 18420) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |