| NPI | 1093155129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL25836) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60324) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2025-10-14 |