| NPI | 1164821062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT023793) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA PT023793) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2017-11-02 |