| NPI | 1285058925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4562) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 10054) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2020-06-09 |