| NPI | 1477398964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT032124) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0014857) |
| 225100000X Physical Therapist (Licence: MA PTL27399) | |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-08-21 |