| NPI | 1134764020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME 5519) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NH 4599) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2023-06-19 |