| NPI | 1902198401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT016491) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 19945) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2019-04-30 |