| NPI | 1043958754 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT033749) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT38714) | 
| Enumeration Date | 2022-05-23 | 
| Last Update Date | 2025-09-26 |