| NPI | 1265849897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 23998) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 3311) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2019-06-20 |