| NPI | 1023564192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT009470L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11770) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2021-03-15 |