| NPI | 1942750484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: ME PA4718) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ME MT3547) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |