| NPI | 1679960397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21680) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 10030) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |