| NPI | 1548915986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 25943) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040340) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |