| NPI | 1205463007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305217527) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT6205) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-12-11 |