| NPI | 1316310964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT 003391) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209011) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |