| NPI | 1275041014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22811) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1314213) |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2020-06-08 |