| NPI | 1902097173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17920) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 7921) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2015-06-10 |