| NPI | 1447639570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 15129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 2522) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |