| NPI | 1629365150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT021460) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0015065) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2020-10-07 |