| NPI | 1053307553 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204197) | 
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305204197) | 
| Enumeration Date | 2005-09-21 | 
| Last Update Date | 2025-06-05 |