| NPI | 1245985571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT38371) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT6156) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |