| NPI | 1912947219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT002631) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT-011195L) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-01-04 |