| NPI | 1720055106 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209891)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60032241)  | 
| Enumeration Date | 2006-03-03 | 
| Last Update Date | 2016-01-25 |