| NPI | 1750006904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24123) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016291) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-10 |