| NPI | 1841840675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24738) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044819-01) |
| 225100000X Physical Therapist (Licence: VT 040.0134103) | |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2020-01-20 |