| NPI | 1255343620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT1672) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: ME C52330) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-01-20 |