| NPI | 1457881161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT004264) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26507) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-04-07 |