| NPI | 1316304553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MA PTL20374) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL20374) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2025-11-28 |