| NPI | 1568010759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME 5930) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24415) |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2023-05-30 |