| NPI | 1710664115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL89142) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0019218) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2025-11-07 |