| NPI | 1871742254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 4723) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 1997) |
| 225100000X Physical Therapist (Licence: ME PT1024) | |
| 225100000X Physical Therapist (Licence: VT 0400002678) | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-09-10 |