| NPI | 1588963367 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 4417) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 0585) | 
| Enumeration Date | 2011-03-20 | 
| Last Update Date | 2011-03-20 |