| NPI | 1356766059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT003694) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007388) |
| 225100000X Physical Therapist (Licence: PA PT023423) | |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2022-11-01 |