| NPI | 1891943379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400071450) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT3461) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2010-10-13 |