| NPI | 1760851034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 12414) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21838) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2019-09-06 |