| NPI | 1215919790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT731) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME 731) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2019-04-01 |