| NPI | 1477976884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024898) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003229) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2016-01-05 |