| NPI | 1043644560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: MD 27549) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ME PA4118) |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2021-03-09 |