| NPI | 1346491131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035038) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 15375) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2021-10-29 |