| NPI | 1619794864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV CP048678T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD CP035054T) |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2025-09-29 |