| NPI | 1023245065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 008535) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 18361) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2015-04-22 |