| NPI | 1649609140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13940) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: MA 20637) | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2021-11-16 |