| NPI | 1851040844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WV PTA002058) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PTA002058) |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-07-26 |