| NPI | 1790162964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT3936) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: ME PT3936) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2022-08-01 |