| NPI | 1265516561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17485) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 06378) |
| 225100000X Physical Therapist (Licence: CT 008070) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2018-08-15 |