| NPI | 1821207150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT2276) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT135) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-08-07 |