| NPI | 1841251089 |
|---|---|
| Former Name | SARAH ELIZABETH EWALDSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT4461) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT2741) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-11-10 |