| NPI | 1821562711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL88702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT017159) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2025-10-16 |