| NPI | 1619305489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: ME PT5156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20630) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2019-01-31 |