| NPI | 1619279908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 9946) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19285) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2020-05-12 |