| NPI | 1326483710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0014428) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 22536) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2021-09-17 |