| NPI | 1942885207 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214264)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA Pending)  | 
| Enumeration Date | 2021-03-17 | 
| Last Update Date | 2021-05-10 |