| NPI | 1487160453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23307) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11579) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |