| NPI | 1588942049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P13669) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT 021555) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2022-06-03 |