| NPI | 1255452967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18931) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 8022) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-01-31 |