| NPI | 1659555340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 4891) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11847) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2020-01-30 |