| NPI | 1619649316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 26753) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214726) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2023-07-02 |