| NPI | 1326476763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003053) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023144) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2016-07-18 |