| NPI | 1740716042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4888) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21592) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2022-01-12 |