| NPI | 1205159720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ME PT4885) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ME MT3588) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2022-07-21 |