| NPI | 1902273881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024737) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 5024) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2018-12-28 |