| NPI | 1508111832 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872215) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208260) | 
| 225100000X Physical Therapist (Licence: CT 9484) | |
| Enumeration Date | 2012-07-24 | 
| Last Update Date | 2018-03-17 |