| NPI | 1598408064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT6761) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 300723) |
| 225100000X Physical Therapist (Licence: NH 4966) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2024-04-02 |