| NPI | 1164871125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22306) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME 4146) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |