| NPI | 1811515893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020020228) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV CP004459T) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2021-06-29 |