| NPI | 1992084412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19587) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 9178) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2024-02-29 |