| NPI | 1104234988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 1884) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 10593) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2024-01-03 |