| NPI | 1164779443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT3981) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH PT3719) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |