| NPI | 1508657040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT033343) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT004835) |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-07-29 |