| NPI | 1003165853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 010015) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 20208) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2019-01-03 |