| NPI | 1194901546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18020) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: MA 18020) |
| 2251X0800X Physical Therapist Orthopedic (Licence: MA 18020) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |