| NPI | 1962978874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 11982) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 23948) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2020-02-14 |