| NPI | 1720336183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT003177) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022275) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2022-11-05 |