| NPI | 1801307004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 17492) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2020-02-09 |