| NPI | 1265405773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 16264) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MA 16264) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MA 16264) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2007-07-08 |