| NPI | 1811101793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 16948) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT015524) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |