| NPI | 1447504162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT023180) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6766) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2014-03-11 |