| NPI | 1720448954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022530) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: PA 770616119) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |