| NPI | 1639694201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT023899) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |