| NPI | 1639724370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029931) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24383) |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2022-08-15 |