| NPI | 1780852269 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT870781) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22200) | 
| 225100000X Physical Therapist (Licence: VA 2305205265) | |
| Enumeration Date | 2008-02-18 | 
| Last Update Date | 2008-05-28 |