| NPI | 1790231942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025557) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003695) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2022-09-20 |