| NPI | 1508160789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 1551) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: MA 1551) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |