| NPI | 1619036266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019956) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 007144-1) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-01-28 |