| NPI | 1619404548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025630) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210308) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2018-03-17 |