| NPI | 1952687048 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207197)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT871107)  | 
| 225100000X Physical Therapist (Licence: CA PT 20473)  | |
| Enumeration Date | 2011-11-02 | 
| Last Update Date | 2012-12-14 |