| NPI | 1780492702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004805) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA CP039209T) |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2025-04-29 |