| NPI | 1962881409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026634) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003404) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2023-06-21 |