| NPI | 1790064368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19148) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 38100) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |