| NPI | 1104883230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 092323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT3135) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-08-24 |