| NPI | 1578688206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21950) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 7622) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-08-12 |