| NPI | 1902141401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022506) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT35224) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2019-12-03 |