| NPI | 1649397472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD PT20742) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME 2200) |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2007-07-08 |