| NPI | 1902468119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24319) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043290) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-09-26 |