| NPI | 1174717607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: WV PT-2615) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT- 07937) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-09-25 |