| NPI | 1881343549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL26957) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0134389) |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2023-07-31 |