| NPI | 1306679790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT6978) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 27891) |
| Enumeration Date | 2024-08-22 |
| Last Update Date | 2024-12-16 |