| NPI | 1780961052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19192) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 4172) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2021-08-02 |