| NPI | 1508189648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18955) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MA 18955) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2021-11-05 |