| NPI | 1306117783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19436) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 005386) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2018-10-11 |