| NPI | 1205370772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4670) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 09520R) |
| Enumeration Date | 2016-12-18 |
| Last Update Date | 2018-05-07 |