| NPI | 1598272569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23127) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT5025) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2021-02-03 |