| NPI | 1679850242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17964) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MA 17964) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MA 17964) | |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2017-07-24 |