| NPI | 1205964731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT3710) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004924) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-10-27 |