| NPI | 1144798828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP015738T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT004395) |
| 225100000X Physical Therapist (Licence: SC PT.9410) | |
| Enumeration Date | 2018-11-11 |
| Last Update Date | 2023-09-14 |