| NPI | 1124856463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT032655) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0014895) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-08-06 |