| NPI | 1407540719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT031276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 30183) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2024-10-28 |