| NPI | 1306180351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: 63164) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 20293) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2020-12-21 |