| NPI | 1790099414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT90) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: ME PT90) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |