| NPI | 1235912569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT031873) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 29600) |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2023-11-09 |