| NPI | 1598144990 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 2376) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ME PA2545) | 
| Enumeration Date | 2015-05-19 | 
| Last Update Date | 2015-05-19 |