| NPI | 1609317213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030991) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23333) |
| 225100000X Physical Therapist (Licence: WV PT004681) | |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2025-09-18 |