| NPI | 1962625400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA DAPT000538) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT009298L) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |