| NPI | 1871964577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024532) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21991) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2021-03-17 |