| NPI | 1124357231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT015863) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 00008953) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2020-05-29 |