| NPI | 1255712204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21770) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1253483) |
| 225100000X Physical Therapist (Licence: ME PT4339) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2017-05-11 |