| NPI | 1407895550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT006197L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 18380) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT002249A) | |
| 225100000X Physical Therapist (Licence: PA DAPT000397) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2017-01-19 |