| NPI | 1629122452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17031) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT030471) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2025-11-13 |