| NPI | 1831736578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL88973) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MA ATL22297) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NH 1608) | |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2025-11-09 |