| NPI | 1649605528 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024158) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 3665) | 
| Enumeration Date | 2013-09-10 | 
| Last Update Date | 2015-01-27 |