| NPI | 1164620118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018102) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: PA PT018102) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2025-10-14 |