| NPI | 1972891398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 7046) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN276087) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |