| NPI | 1760616668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018661) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 028552) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: PA PT018661) | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2019-05-09 |