| NPI | 1326414053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22295) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 039223) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2023-07-24 |