| NPI | 1528110632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT004596) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT19089) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2026-06-03 |