| NPI | 1689190480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23236) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT029482) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2023-02-16 |