| NPI | 1033662077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24279) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA #09448) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2021-03-02 |