| NPI | 1811700974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL23422) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT7025) |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-10-24 |