| NPI | 1801274568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT032309) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P15595) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2025-04-22 |