| NPI | 1912485194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004891) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WV 002483) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2023-12-11 |