| NPI | 1275904781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT004580) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 29487) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2022-12-05 |