| NPI | 1790202612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 011484) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2019-08-12 |