| NPI | 1306148655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT002897) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2024-11-15 |