| NPI | 1164520482 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC 870112) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305203115) | 
| 225100000X Physical Therapist (Licence: CA PT32836) | |
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2016-09-30 |