| NPI | 1295491819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT6656) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MA 25873) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2023-11-06 |