| NPI | 1013435668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT003904) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 28381) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2024-12-02 |