| NPI | 1548877426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025681) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26854) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2021-12-29 |