| NPI | 1649512666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4026) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ME MT4100) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2023-11-13 |