| NPI | 1164979761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026511) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210639) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2020-10-02 |