| NPI | 1528786183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL26894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02104800) |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2023-06-07 |