| NPI | 1639475775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019939) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT002927) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2014-11-07 |