| NPI | 1679555338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 1831) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT2141) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2007-07-08 |