| NPI | 1114178621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT008732E) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 18047) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |