| NPI | 1992920003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 9524) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2021-08-02 |