| NPI | 1114214699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ME PA2640) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ME MT2944) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2011-07-05 |