| NPI | 1205729464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP054148T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT004871) |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2026-03-13 |