| NPI | 1679834501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0002858) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021901) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2013-05-01 |