| NPI | 1346604154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 19201) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MA 19201) |
| 225100000X Physical Therapist (Licence: MA 19201) | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2022-05-13 |