| NPI | 1376110361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: MA 26458) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MD 28436) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2024-05-22 |