| NPI | 1013985795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0003503) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT2982) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-05-16 |