| NPI | 1811960826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME pt2151) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VT 0400003576) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2009-07-09 |