| NPI | 1548774870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23637) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 10050) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2020-01-16 |