| NPI | 1790067528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT021854) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002752) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2022-02-01 |