| NPI | 1376684191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA DAPT001446) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070012620) |
| 225100000X Physical Therapist (Licence: PA PT018611) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004135) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.001802) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2008-05-27 |