| NPI | 1174754980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT01422L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT014022L) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2013-05-23 |