| NPI | 1750149241 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ME PA6100) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ME MT2094) | 
| Enumeration Date | 2024-03-08 | 
| Last Update Date | 2024-03-08 |