| NPI | 1609083567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019020) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008968A) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-03-29 |