| NPI | 1164159976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030575) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA TPT023557) |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2023-03-06 |