| NPI | 1154613180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 10951) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT2937) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2012-06-28 |