| NPI | 1932588126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4380) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1243028) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2020-07-17 |