| NPI | 1972859825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20044) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 17277) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2019-10-23 |