| NPI | 1720475775 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21065) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21995) | 
| 225100000X Physical Therapist (Licence: DC PT870739) | |
| Enumeration Date | 2015-04-16 | 
| Last Update Date | 2015-04-16 |