| NPI | 1689981763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT3866) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2003012268) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2018-08-22 |