| NPI | 1598292245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026010) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26949) |
| 225100000X Physical Therapist (Licence: WV PT003782) | |
| 225100000X Physical Therapist (Licence: NC P17448) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2022-07-20 |