| NPI | 1740305259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 00002921) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 16837) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-08 |