| NPI | 1497265219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4644) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10514) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |