| NPI | 1679690622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 9433) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 9433) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2019-02-13 |