| NPI | 1770874331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ME PA4168) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT407) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2016-02-10 |