| NPI | 1750316816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 16225) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 004171) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-08-06 |