| NPI | 1306028097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT002748) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004678) |
| 225100000X Physical Therapist (Licence: WV 002748) | |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2023-06-28 |