| NPI | 1417432774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL24753) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11909) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2025-10-15 |