| NPI | 1710359930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 25821) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 022036-1) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2022-07-11 |