| NPI | 1619177730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA DAPT005111) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT26296) |
| 225100000X Physical Therapist (Licence: TX 1166490) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2022-08-02 |