| NPI | 1659583029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 16506) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008014) |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2007-07-08 |