| NPI | 1275187957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 02305004220) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 001083) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: WV 001083) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: VA 2305004220) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |