| NPI | 1255879359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: PA PT028079) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1286931) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2022-01-10 |