| NPI | 1154963973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT6093) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044999) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2025-04-08 |