| NPI | 1265919591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026807) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0014503) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2024-05-06 |