| NPI | 1215426655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: MA 24856) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT4834) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2025-06-23 |