| NPI | 1831652015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029385) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 34453) |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2021-05-20 |