| NPI | 1699359638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 25478) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA TBD) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2021-05-06 |