| NPI | 1003125345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19295) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6625) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2015-11-17 |