| NPI | 1730334392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 10872) |
| 2251S0007X Physical Therapist, Sports (Licence: MA 10872) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MA 10872) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA AT916) | |
| 246ZA2600X Specialist/Technologist, Other, Art, Medical | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2016-05-19 |