| NPI | 1467985770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4983) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62948) |
| 225100000X Physical Therapist (Licence: MN 10557) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2019-03-19 |