| NPI | 1720050719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 25266) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 007533) |
| 225100000X Physical Therapist (Licence: SC 7448) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2023-03-23 |