| NPI | 1194130641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25039) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003345) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |