| NPI | 1205312063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P18091) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003464) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |