| NPI | 1841806957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: WV PT004296) |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2021-11-17 |