| NPI | 1124388780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 9588) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 1542) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |