| NPI | 1902152440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61757) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT2613) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2017-07-11 |