| NPI | 1679160840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24783) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 4751) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2024-04-17 |