| NPI | 1063159283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT004662) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: PA PT030557) | |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2023-10-04 |