| NPI | 1215481627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22400) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA 664646) |
| 2251S0007X Physical Therapist, Sports (Licence: MA SP20071) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MA 22400) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2024-09-13 |