| NPI | 1902888993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT005735L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT000476) |
| 225100000X Physical Therapist (Licence: DE J10001967) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT001764A) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2023-12-18 |