| NPI | 1689116949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 11563) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22744) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2025-08-18 |