| NPI | 1790066702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19596) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: MA 19596) |
| Enumeration Date | 2011-09-03 |
| Last Update Date | 2014-01-31 |