| NPI | 1689311417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT7171) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2025-06-06 |