| NPI | 1245898782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT027061) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0014827) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2025-10-08 |