| NPI | 1790236388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003187) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025592) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2019-03-04 |