| NPI | 1457128746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-033357) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL88729) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2025-12-22 |