| NPI | 1366038861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004358) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10510) |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2022-03-08 |