| NPI | 1588034649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT6991) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 4171687) |
| 225100000X Physical Therapist (Licence: CT 15164) | |
| 225100000X Physical Therapist (Licence: PA PT033760) | |
| 225100000X Physical Therapist (Licence: MA PTL19092) | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2026-02-18 |