| NPI | 1881957025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 003006) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 021934) |
| 2251P0200X Physical Therapist Pediatrics | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2021-06-22 |