| NPI | 1811142755 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT870619) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204936) | 
| Enumeration Date | 2008-11-19 | 
| Last Update Date | 2008-11-19 |