| NPI | 1558710798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025185) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT004106) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2019-03-04 |