| NPI | 1609257997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026405) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0013351) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2020-01-30 |