| NPI | 1740999275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL27402) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P24398) |
| Enumeration Date | 2022-11-23 |
| Last Update Date | 2025-10-22 |