| NPI | 1669916433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 011206) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24750) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2023-10-06 |