| NPI | 1073031530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT03272) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PPT33036) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2020-07-27 |