| NPI | 1194160648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 15635) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: NH 2650) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2023-08-08 |