| NPI | 1982147815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT292173) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20976) |
| Enumeration Date | 2016-11-26 |
| Last Update Date | 2016-11-26 |