| NPI | 1194273219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4537) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13295-24) |
| Enumeration Date | 2016-09-18 |
| Last Update Date | 2020-07-29 |