| NPI | 1528474335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20913) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62036168) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |