| NPI | 1659082188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004561) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WV 004561) |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |