| NPI | 1790794493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 3135) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17616) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-12-30 |