| NPI | 1679125975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT027743) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2023-01-09 |