| NPI | 1649523507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022367) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003050) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |