| NPI | 1215145099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL8482) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 9551) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2025-09-02 |