| NPI | 1720637002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0014433) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT027952) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2021-11-01 |