| NPI | 1730962200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL81044) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 121096) |
| 225100000X Physical Therapist (Licence: FL PT41172) | |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2025-05-22 |