| NPI | 1518681428 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0014708) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT030731) | 
| Enumeration Date | 2022-10-04 | 
| Last Update Date | 2023-08-22 |