| NPI | 1548637770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21933) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0112832) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2021-08-31 |